Blowing The Whistle On Medicare Fraud

Whistleblowing

Recently, in the news and elsewhere, whistleblowing has become a hot topic of discussion. Most recently, whistleblowing has also drawn attention due to the awards given out by organizations such as the Internal Revenue Service and Securities and Exchange Commission. Yet, healthcare and Medicare fraud has drawn whistleblowers out of the woodwork and into the spotlight recently, and this example is no exception.

The Allegations

A recent whistleblower lawsuit against UnitedHealth Group may prove to be a massive case, as it is reported that the scheme carried out by the healthcare group may have defrauded Medicare by hundreds of millions in the form of overcharges. The case alleges that private Medicare Advantage insurers boosted submitted claims for diagnoses that health plan members didn’t have or for which members weren’t being treated. In other words, Medicare paid out for care that was never required — and never took place. On a huge scale, the suit alleges. The whistleblower was the director of finance for the group, which insures 2.2 million people through its Medicare Advantage program.

What This Means

If the whistleblower suit is successful, this could mean a huge recovery for the federal government And hopefully systemic changes that would render such fraud impossible going forward. We will look to the government to pursue the investigation and await a judgment. The case is another example of a whistleblower citizen, with credible information, coming forward to help the government prosecute wrongdoing. The government provides large incentive rewards as well for this good citizenship.

Contact Us

If you or a loved one has information regarding a potential whistleblower case and is looking to be a whistleblower in Sonoma County or in any California county, contact the Evans Law Firm whistleblower attorneys at (415) 441-8669, or by email at info@evanslaw.com. Our attorneys have experience with complex financial contracts and large insurance companies. We can help guide your case through a jury trial or toward an equitable settlement. We handle cases involving physical and financial elder abuse, qui tam and whistleblower law, nursing home abuse, whole life insurance and universal life insurance, and indexed, variable, and fixed annuities.